Provider Demographics
NPI:1033535703
Name:BADER, DEBORAH (APN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BADER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:M
Other - Last Name:BROWNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1443 OTTAWA CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2962
Mailing Address - Country:US
Mailing Address - Phone:732-522-4868
Mailing Address - Fax:732-255-5659
Practice Address - Street 1:40 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1654
Practice Address - Country:US
Practice Address - Phone:732-522-4868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00473300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health